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Diagnostyka i leczenie toksoplazmozy ocznej
Diagnosis and Treatment of Ocular Toxoplasmosis
Lidia Stopyra 1 , Wiktor Stopyra 2
1 Oddział Chorób Infekcyjnych i Pediatrii Szpitala Specjalistycznego im. Stefana Żeromskiego w Krakowie
Kierownik: lek. Lidia Stopyra
2 Szpital Okulistyczny MW-med w Krakowie
Kierownik: dr n. med. Włodzimierz Miniewicz
Summary: Ocular toxoplasmosis is the most common infection of uveitis and retina. It is caused by the intracellular protozoan Toxoplasma gondii. The infection takes place via food, transplacental (congenital form) and sporadically during transplantation. Necrotizing retinitis and choroiditis and local vitreous exudate is a characteristic picture of the classic form of ocular toxoplasmosis. Indirect methods (serological tests) and direct methods (polymerase chain reaction and pathogen isolation) are used in laboratory diagnostics. Optical coherence tomography fluorescein or indocyanine green angiography as well as ocular ultrasonography are very helpful in diagnostic imaging. The pharmacological treatment of ocular toxoplasmosis is reserved for lesions located near macula, the optic disc or in the case of widespread inflammatory reaction in the vitreous. Sulfadiazine and pyrimethamine which are unavailable in Poland are the most effective while clindamycin and azithromycin are less effective. Steroids are used only to reduce inflammatory response induced by the local disintegration of protozoan metabolism products in the start of causative treatment. Careful washing of fruits and vegetables before eating them, avoiding the consumption of raw meat as well as special hygiene when working with soil and sand especially contaminated with cat’s feces are the most important in prophylaxis for toxoplasmosis.
Słowa kluczowe: toksoplazmoza oczna, testy serologiczne, dno oka, sulfadiazyna, pirymetamina.
Keywords: ocular toxoplasmosis, serological tests, fundus, sulfadiazine, pyrimethamine.